'Science of medicine; the art of care'

World celebrates nurses and midwives

Photo of a nurse taking the blood pressure of pregnant woman.

For more than half a century, Mount Royal’s nursing program has played a significant role in supporting and maintaining the health and vitality of Albertans, Canadians and citizens around the world.

British medical journal The Lancet put it simply: “Without nurses and midwives there would be no health care.”

As we celebrate Nursing Week from May 12 to 17, it is well worth remembering that whether it’s caring for mothers and children; providing lifesaving immunizations and health advice; looking after our elders, and generally meeting everyday essential health needs, nurses and midwives around the world are often the first and only point of care in their communities.

Wherever they are, they play a lead role in keeping us well and helping us heal. And we need more of them. The World Health Organization estimates the world requires nine million more nurses and midwives if it is to achieve universal health coverage by 2030.

To emphasize their importance and celebrate the work they do, and to mark the 200th anniversary of the birth of founder of modern nursing Florence Nightingale, the WHO designated 2020 the International Year of the Nurse and the Midwife. The WHO also released on World Health Day (April 6) the landmark State of the World’s Nursing 2020 Report.

“Today, many nurses find themselves on the frontline in the battle against COVID-19. This report is a stark reminder of the unique role they play, and a wakeup call to ensure they get the support they need to keep the world healthy,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director General, while releasing the report.

The WHO and partners, including the International Confederation of Midwives, International Council of Nurses, Nursing Now and the United Nations Population Fund are in the midst of this year-long effort to celebrate the work of nurses and midwives, highlight the challenging conditions they often face, and advocate for increased investments in the nursing and midwifery workforce. The current pandemic, while putting a damper on many of those planned celebrations, has only made it more clear the vital services both provide.

And while the Government of Alberta’s budget woes are challenging the system to do more with less, the province has continued with initiatives to give more power to nurses and midwives. For nurses, that meant expanding the scope of practice for registered nurses and nurse practitioners, allowing them to prescribe drugs in places like travel clinics, sexually transmitted infection programs and workplace health and safety clinics. Nurse practitioners were given new permissions to set bone fractures, while midwives with additional training will be able to prescribe, dispense and administer a broader range of prescription drugs, insert IUDs and perform ultrasounds.

WHO spotlight for worldwide contributions

Photo of Mount Royal University associate professor of midwifery Susan Jacoby holding a newborn baby.

On May 5, International Day of the midwife, Susan Jacoby assisted in a birth whose midwife was an alumnus of the Mount Royal University program and former student of hers.

Mount Royal University associate professor of midwifery Susan Jacoby is one of several midwives who have volunteered to staff the COVID-19 maternity unit at Foothills Medical Centre. The AHS Provincial Midwifery Administrative Office created the position of In-Hospital Midwifery Services as part of the AHS pandemic response in order to limit potential exposure to community midwives. She has been working as a Registered Midwife at Foothills in triage and labour and delivery since the call went out for volunteers.

On May 5, International Day of the Midwife, Jacoby assisted in the birth of baby Aria to Christine Jang. The midwife at the birth was Chandra Martini an alumnus of the MRU program and former student of Jacoby’s.

“It was a marvelous way to celebrate International Day of the Midwife during the International Year of the Nurse and Midwife.”

Jacoby spent a number of months working with the WHO while on a sabbatical and helped the organization prepare for the Year of the Nurse and the Midwife.

“Nurses and midwives comprise 50 per cent of global health care providers, but this is the first time in the 73-year history of the World Health Organization that we have been celebrated for our contributions to health care,” she says.

Jacoby began working at the WHO in Geneva, Switzerland, on Sept. 1, 2019, in the Department of Reproductive Health with Dr. Christina Pallitto, the lead scientist on projects related to female genital mutilation (Jacoby’s area of research expertise). The research project she was matched with was delayed, so she was seconded to work with Elizbeth Iro, the first Chief Nurse Officer of WHO, a nurse and a midwife of Maori descent from the Cook Islands. As part of her team, Jacoby assisted with several projects, including the State of the World’s Nursing Report.

Other projects included developing the one-stop-shop Nursing & Midwifery Resource Centre; co-authoring an article for the Lancet on “Delivering on global health priorities: the WHO Task Force on Nursing and Midwifery”; and contributing to numerous WHO consultations and reports on nursing and midwifery.

Jacoby also wrote and co-directed an original play called Born in the Ruins in celebration of International Day of the Midwife and International Nurses Day. It was performed live at WHO for the director general and country mission ambassadors in Geneva in May 2019 and live-streamed to 134 countries. The play was also shown to the United Nations High Level Commission meeting for universal health coverage 2030 in New York.

“I am a nurse and a midwife with 40 years experience in maternal-child health and have always believed that midwifery is a calling, not just a job,” Jacoby says. “I am grateful that my avocation and my vocation are one and the same. I have years of accumulated experiences about birth that I share with my students to try and make the didactic and hands-on learning experiences come alive for them. I have a passion for midwifery and I want to share that with them, because you have to be passionate about mothers and babies. They deserve nothing less.”

The COVID-19 crisis put many international celebrations for the Year of the Nurse and the Midwife on hold, and also meant a planned event at MRU could not go ahead that would have honoured former Mount Royal University's director of the School of Nursing and Midwifery, Paula Price, PhD.

Organizers of the day-long gathering had hoped to focus on ways nursing and midwifery can collaborate with other practitioners, featuring speakers whose work and legacy speak to their contributions in healthcare.

“Nurses and midwives are too busy trying to care for the people we serve to stop and consider that we are the reason this year was proclaimed the Year of Nursing and Midwifery,” Jacoby says.

“We are working long hours on the front line and desperately trying to keep people from dying — even at risk to ourselves. I hear people banging on pots and pans every evening at 7 p.m. to demonstrate their appreciation, and it’s lovely to see that people are grateful for the work we do. However, in some countries health-care workers are being vilified and attacked as being sources of the virus. This is indeed concerning for all of us. I hope that at the end of the day, the world will have a greater appreciation for the work that nurses and midwives do to keep their communities well.”

MRU anticipated evolving role in health care

Photo of a nurse with young boy using a stethoscope.

Since 1967, Mount Royal has been educating and training thousands of highly skilled professionals, setting a continued standard of excellence demonstrated by the incredible sacrifices being made by our graduates today.

Canada’s first two-year nursing diploma program at what was then Mount Royal Junior College enrolled 25 students in 1967. Nursing education at Mount Royal has kept pace with rapid changes in the decades since, anticipating the evolving role of nurses and midwives. In 2007, the Bachelor of Nursing program began. It was Mount Royal’s first independent baccalaureate and now welcomes 215 eager students each fall, far fewer than apply. In 2011, recognizing an unfulfilled need, Mount Royal re-organized the nursing programs under the School of Nursing and Midwifery to include the Bachelor of Midwifery — the only program of its kind in Alberta. The School also offers the Bridge to Canadian Nursing and Advanced Studies in Critical Care Nursing.

Kerri Alderson, an associate professor in the nursing program at MRU and formerly a practising nurse in a variety of health-care settings across North America, stresses that nurses affect change across the lifespan, and have the ability to influence the trajectory of health at an individual, community, and population level.

“We are gifted with the ability to interact with people at critical moments in their lives, and adapt our knowledge and skills to affect change for better outcomes. Often, it is a conversation with a nurse or a midwife that enables people to recognise their own strengths, and collaborate to work out a solution to overcome the personal or systemic challenges they face.”

Alderson says she became a registered nurse for the reason many do: a desire to help people. She says she tries to take that same desire to help her students exhibit, and turn it into far more.

“While this altruism is a desirable characteristic for a nurse or midwife, it is my role and responsibility to guide their awareness that the ability to assist patients also carries great responsibility: you have to know to care. Without practising with evidence-based knowledge and skills and being deliberate in their approach, their intention to help might very well be the opposite. Safety is always our first priority in providing care.”

Students are the future

Shani Markus, a second-year student and president of MRU’s Student Nursing Society says that the broad and varied role nurses play in health advocacy and leadership drew her to the profession.

“It is important to recognize the diversity of jobs in the nursing profession — I think lots of people just view nurses as hospital workers, which are very valuable, when in reality nurses can choose to work in the community, serving several populations. Nurses act as a backbone to our healthcare systems, communities and education systems.”

Andrew Nguyen, former president of Students Association of Mount Royal University and a fourth-year student who is now caring for COVID-19 patients in an intensive care unit, says he chose nursing “because it combines the science of medicine and the art of nursing care. This is important for me because I wanted to gain medical knowledge while providing direct front-line care. I chose nursing because I wanted to work with patients and their families navigating very difficult health situations and circumstances.

“It is important to celebrate the work of nurses since we are often overlooked for the Christmases we work, the risk of bringing home diseases (like with COVID-19), and the unclocked hours that we put in to ensure we are providing the best patient care.”

What is a nurse?

Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management and education are also key nursing roles.

Learn about the School of Nursing and Midwifery in the Faculty of Health, Community and Education. Read how MRU nursing and midwifery students are being fast-tracked into the workforce to help during the COVID-19 crisis.

May 11, 2020 — Peter Glenn

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